高渗葡萄糖增生疗法诱导新细胞增殖修复软组织缓解疼痛:现状与问题

Dextrose prolotherapy induces the proliferation of new cells to repair soft tissue and to alleviate pain: current status and problems

背景:高渗葡萄糖增生疗法是一种在肌腱和韧带附着于骨组织的部位注入增殖剂来诱导新细胞的增殖来修复软组织的疼痛管理方法,因其价格低廉、安全性高,临床应用逐渐增多。目的:就高渗葡萄糖增生疗法的概念、目前机制研究、临床研究、注意事项、禁忌证及不良反应等方面进行综述。方法:结合英文检索词(hypertonic glucose、Dextrose Prolotherapy、proliferation therapy)和中文检索词(高渗葡萄糖、增生疗法),检索PubMed、Embase、The Cochrane Library、CNKI(中国知网)、cqVIP(维普资讯网)、万方全文数据库,搜索关于高渗葡萄糖增生疗法的特点、产生及发展相关领域的文章,并进行总结和综述。结果与结论:相关细胞研究及动物实验研究了高渗葡萄糖在促进软骨修复、促纤维化以及神经血管效应方面的作用。临床研究也表明高渗葡萄糖增生疗法可以治疗多种类型的软组织损伤与疼痛类疾病,但目前实验研究机制较单一,临床试验异质性较大,随访时间较短,因此仍需开展大量的科学严谨的实验机制研究来阐明其具体机制,以及开展高质量、高同质性、长期随访的随机对照试验来验证高渗葡萄糖增生疗法的临床疗效。

BACKGROUND:Dextrose prolotherapy is a pain management method that injects a proliferation agent to induce the proliferation of new cells to repair soft tissue at the site where the tendon and ligament are attached to the bone tissue.Due to its low price and high safety,clinical applications are gradually increasing.OBJECTIVE:To summarize the concept of hyperosmotic glucose hyperplasia therapy,current mechanism research,clinical research,matters needing attention,contraindications,side effects and adverse reactions.METHODS:Keywords of “hypertonic glucose,dextrose prolotherapy and proliferation therapy” in English and Chinese were used in PubMed,Embase,The Cochrane Library,CNKI,VIP and WanFang databases.The articles related to the characteristics,generation and development of hypertonic glucose hyperplasia therapy were retrieved and summarized.RESULTS AND CONCLUSION:Related cell studies and animal experiments have investigated the role of hypertonic glucose in promoting cartilage repair,profibrosis,and neurovascular effects.Clinical studies have shown that dextrose prolotherapy can treat many types of soft tissue injury and pain-like diseases,but the current experimental research mechanism is relatively simple,clinical trials are heterogeneous,and the follow-up time is short,so a lot of scientific studies on experimental mechanism still need to be carried out to clarify its specific mechanisms.High-quality,high homogeneity,long-term follow-up randomized controlled trials should be conducted to verify the clinical efficacy of dextrose prolotherapy.